Vitamin D Deficiency in Pregnancy May Raise Risk of Multiple Sclerosis In Offspring Interview with:
Kassandra Munger, Sc.D.
Harvard T.H. Chan School of Public Health What is the background for this study?

Dr. Munger: Previous work has shown that adequate vitamin D nutrition is associated with a lower risk of multiple sclerosis (MS).  Results from studies examining whether adequate vitamin D exposure during early-life are also associated with a lower risk of MS have been mixed.  One study reported that daughters of mothers with high dietary vitamin D intake during their pregnancy had a reduced risk of multiple sclerosis, while two studies measuring 25-hydroxy vitamin D either in a blood sample from the pregnant mother or from a sample taken from the neonate, were not associated with future multiple sclerosis risk in the child. What are the main findings?

Dr. Munger: We conducted a nested case-control study within the Finnish Maternity Cohort—a cohort of over 800,000 women with a blood sample collected and stored during their pregnancy.  We identified 176 cases of multiple sclerosis among the offspring born between 1983 and 1991, and matched them to 326 controls.  We found that the offspring of mothers who were vitamin D deficient (25-hydroxyvitamin D <12.02 ng/ml [<30 nmol/L]) during the pregnancy with the child had a 90% increased risk of developing  multiple sclerosis in adulthood as compared to offspring of mothers who were not deficient. What should clinicians and patients take away from your report?

Dr. Munger: Identifying and correcting vitamin D deficiency during pregnancy may reduce risk of  multiple sclerosis in the offspring.  However, it is premature to recommend specifically that pregnant women increase their vitamin D intake for the purpose of reducing their child’s multiple sclerosis risk. What recommendations do you have for future research as a result of this study?

Dr. Munger: Confirmation of our findings in other studies and populations is necessary.  Further, to what extent the association observed is due to a true biological effect or a behavioral effect needs additional study.  The possibility that the factors leading to vitamin D deficiency in the mother during her pregnancy (e.g. not taking supplemental vitamin D) may be behaviors that are passed on to the child and it is deficiency in the child that is driving the association. Is there anything else you would like to add?

Response: In addition to vitamin D nutrition, other modifiable risk factors associated with multiple sclerosis risk include cigarette smoking and obesity in childhood/adolescence.  Encouraging their children to not smoke and to maintain a healthy body weight are other strategies parents can use to potentially reduce MS risk in their children. Thank you for your contribution to the community.

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Alberto Ascherio, MD, DrPH et al. Vitamin D Status During Pregnancy and Risk of Multiple Sclerosis in Offspring of Women in the Finnish Maternity Cohort. JAMA Neurol, March 2016 DOI:10.1001/jamaneurol.2015.4800


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Kassandra Munger, Sc.D. (2016). Vitamin D Deficiency in Pregnancy May Raise Risk of Multiple Sclerosis In Offspring

Last Updated on March 8, 2016 by Marie Benz MD FAAD